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Effectiveness of preventative care strategies for reducing pressure injuries (PIs) in children aged 0-18 admitted to intensive care: A systematic review and meta-analysis

Setchell, Bradley; Marufu, Takawira C; Nelson, David; Manning, Joseph C

Authors

Bradley Setchell

Takawira C Marufu

David Nelson

Joseph C Manning



Contributors

Joseph Manning
Supervisor

Abstract

Introduction: The development and prevention of pressure injuries is a complex phenomenon, dependent on a wide variety of extrinsic and intrinsic risk factors. Children with critical illness form an extremely vulnerable patient group with an exceptionally high risk of immobility-related and medical device-related pressure injuries. Recent reviews on this subject matter largely been focused on adult patients. The aim of this review is to systematically synthesise the evidence on the most effective interventions to prevent pressure injury development in children admitted to intensive care.
Methods: Four electronic databases; CINAHL, MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials were searched. Studies were screened at three stages, title, abstract, and full text against the inclusion and exclusion. Quality appraisal was conducted using the Joanna Briggs Institute Critical Appraisal Tools and two authors independently extracted study data from included studies using a predesigned data collection form. A meta-analysis was performed using RevMan 5.
Results: After removal of duplicates, twenty studies met the inclusion criteria. Observed interventions included; use of risk assessment tool, preventative skin regimes, nutrition, repositioning, support surfaces, medical devices care, and staff education and training. A bundle intervention approach was used to implement pressure ulcer preventative strategies. Meta-analysis demonstrated an associated 51% potential reduction in pressure injury post intervention (pooled OR 0.49 (95% confidence Interval (CI) 0.39 – 0.62) P < 0.0001).
Conclusion: Pressure injury preventative strategies are more likely to reduce the number and severity of pressure injuries. Paediatric nurses are pivotal members of the direct care multidisciplinary team with unique expertise and influence over the risk assessment, implementation and maintenance of pressure injury preventative strategies for children admitted to intensive care.

Citation

Setchell, B., Marufu, T. C., Nelson, D., & Manning, J. C. (2023). Effectiveness of preventative care strategies for reducing pressure injuries (PIs) in children aged 0-18 admitted to intensive care: A systematic review and meta-analysis. Journal of Tissue Viability, 32(2), 228-241. https://doi.org/10.1016/j.jtv.2023.04.001

Journal Article Type Article
Acceptance Date Apr 3, 2023
Online Publication Date Apr 28, 2023
Publication Date May 1, 2023
Deposit Date Apr 5, 2023
Publicly Available Date Mar 28, 2024
Journal Journal of Tissue Viability
Print ISSN 0965-206X
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 32
Issue 2
Pages 228-241
DOI https://doi.org/10.1016/j.jtv.2023.04.001
Public URL https://nottingham-repository.worktribe.com/output/19289889
Publisher URL https://www.sciencedirect.com/science/article/pii/S0965206X23000396

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